NURS 534 Final Exam Questions with 100% Correct Answers

What are the medical treatments for hot flashes? Correct Answer -Estrogen- principal treatment -progestins- can be used if contraindicated for estrogen BUT increased RISK for BREAST CA - Clonidine- centrally acting alpha agonist - SSRI and SNRI -Gabapentin- decrease HF b 50-80% what factors lower the menopause date? Correct Answer smoking, nulliparity, menstrual regularity and shorter cycle length, family hx of early menopause, increased galactose intake, type 1 DM, What defines menopause? Correct Answer -amenorrhea for 1 year - What are diagnostic tests for menopause? Correct Answer - TSH - HCG - CBC - pap -endometrial biopsy - transvaginal US -FSH 40 -LH What are some perimenopause symptoms? Correct Answer - sleep disturbances - mood disturbances - somatic symptoms (fatigue, palpitations, headache, increased migraine, breast pain and enlargement) -oligio- anovulation What are some ways to manage of menopause symptoms? Correct Answer - aerobic exercise -dietary habits- high complex carbs - stress reduction -smoking cessation - herbal therapies- isoflavonoid and black cohosh what are the vaginal/urogenital symptoms of menopause and how are they treated? Correct Answer - decrease in estrogen produce atrophic changes in bladder and urethra epithelium - increased risk for atrophic cystitis- urgency, frequency, incontinence, dyuria - disappearance of lactobacilli can increase vaginal infections - loss of support of the urethrovescical junction can lead to stress urinary incontincence - treatments- pap smearand u/a- r/o infx -topical vaginal application of estrogen product- estradiol ring, or estrogen vag rin - water soluble vag lubricants -sitz bath, vinegear douches, -kegels exercises What is the menopausal metabolic syndrome? Correct Answer - lipid triad- hypertriglyceridemia, increased LDL and decreased HDL - abnorms of insulin- insulin resistance, increased insulin secretion- hyperinsulinemia - other factors- endothelial dysfunction, increased visceral fat what is the recommendation for HRT? Correct Answer -only for women with moderate to severe symptoms -not for prevention of heart disease or stroke, dementia -used for vasomotor symptoms- hot flashes, night sweats disturbed sleep patterns, concentration, memory -prevent/treat osteoporosis- hip and vertebrae - GU atrophy- bladder irritability, vaginal dryness, dyspareunia -MINIMUM dose for shortest time required what are the the concerns with HRT? Correct Answer - increased risk for VTE -increased risk for breast CA with prolonged use -increased risk for endometrial cancer with ET -increase risk for cardiac events for older women with EPT -probable increase in strokes what are contraindications to HRT? Correct Answer undiagnosed vaginal bleeding, -acute vascular thrombosis, -active liver disease with abn LFTs -history of endometrial or breast cancer -active or recent angina/MI -uncontrolled HTN -pregnancy or breast feeding What are the WHI 5 poits of agreement? Correct Answer 1. for younger women, HRT is acceptable for mod/severe menopausal young women 59yo 2. women with a uterus need to take progesterone along with estrogen to prevent cancer of the uterus 3. Women who have vaginal symptoms only preferred treatment is low doses of vaginal estrogen 4. Both estrogen and progesterone increase the risk of blood clots 5. An increased risk of breast CA is seen in 3-5 years of continuous estrogen/progesterone therapy